After 3 letters to my insurance company, Kaiser, and phone calls to their appeals department; I found out that Kaiser of Colorado is updating their policy to include coverage of sensors for people who have hypoglycemic unawareness.
I’m glad to hear this as I like wearing the sensor but it is tough to pay for it without insurance coverage.
I have more information about my fight at http://www.BadKaiser.com
Its great to hear that you won with Kaiser. I am not sure what to do about my situation because I definatly need help. After having great control for 2 straight years I was diagnosed with Addison’s disease (on top of Type 1 Diabetes). To make a long story short for 3 straight months I was continually diagnosed with Lyme disease by all of my Kaiser doctors. They wouldn’t cover me to go get a second opinion neither. Eventually I was taken to an ER on my death bed and put into an ICU. A Joslin Endocrinologist diagnosed me with Addison’s almost instantly upon looking at me. Now no matter what I do I just can’t avoid lows. Joslin recommends CGM as well as an insulin pump but I have concerns about Kaiser not covering especially with how stubborn they have been up to this point. Any advice? I could try to swith to Blue Cross but the premiums are much higher.
In my experience, to win with Kaiser, you need to be very persistent. Keep sending letters and calling. I didn’t feel like I called that often, but I guess most people don’t call, so when I did call they knew who it was without me even giving my name!
Even when I gave my experience of 2 lows with paramedic visits over 4 days, they still denied me. I think they eventually realized that I would not give up so it made more sense to change the policy. The policy takes time to get changed, but they are providing me with sensors so I can use the CGM.
I can’t write enough about the CGM, it helps me so much and gives me peace of mind. When I wear it, I don’t have to worry if I am going low which is a great benefit.
Also, let them know that you know that Kaiser Colorado has already approved the CGM in Colorado for people with diabetes who have hypoglycemic unawareness and other medical issues which might include Addison’s.
Hope this helps.